There is a small but stubborn percentage of children in the United States who are not immunized. The choice to immunize is not theirs to make. Rather, it’s the parents of these kids who refuse to protect them from very real and very preventable diseases that sicken, maim, and kill children the world over, including in the U.S. And as we’ve seen from the international transmission of H.I.V. a generation ago, measles a few years ago, and Ebola most recently, it’s a small world after all.
The good news is that that this percentage of unimmunized children — 1.8% according to the CDC (more than those who believe Earth is flat and less than those who deny global climate change is really happening) — is pretty static. If this percentage was uniform across these 50 states, no one would be worried about the erosion of “herd immunity” caused by the unvaccinated. The bad news, at least in states like Oregon, where 7.1% of parents opt out of vaccines, is that there are pockets of areas where the refusal rates are much, much higher than the national rate of 1.8%. Some areas in Southern California, says Gary Baum, have vaccination rates so abysmally low that, “according to World Health Organization data, such numbers are in line with immunization rates in developing countries like Chad and South Sudan” (my emphasis):
THE KIDS AREN’T ALL RIGHT. Across California, thousands of children and babies are coughing so violently that their bodies convulse, uncontrollably wheezing and fighting to breathe for weeks. Nearly 8,000 pertussis cases have been reported in 2014 to the state’s Department of Public Health as of Sept. 2, and 267 of those patients have been hospitalized, including 58 requiring intensive care.
Adults can contract the disease, but 94 percent of all cases reported statewide involve children — and the youngest suffer the most. So far this year, three infants under 2 months of age have died statewide from pertussis, a disease commonly known as whooping cough (named for the high-pitched sound that kids make when they inhale after coughing).
These aren’t poor communities in California, mind you. Far from it:
The region stretching from Malibu south to Marina del Rey and inland as far as La Cienega Boulevard (and including Santa Monica, Pacific Palisades, Brentwood, West Hollywood and Beverly Hills) averaged a 9.1 percent PBE level among preschoolers for the 2013-14 school year — a 26 percent jump from two years earlier. By comparison, L.A. County at large measured 2.2 percent in that period. Many preschools in this area spiked far higher, including Kabbalah Children’s Academy in Beverly Hills (57 percent) and the Waldorf Early Childhood Center in Santa Monica (68 percent).
Why would anyone want to expose their own children to such Third-World infectious conditions? Why? It’s a fascinating question and Steven Novella has some ideas:
In addition to overreliance on instinct and general scientific illiteracy and innumeracy, what other psychological factors among the privileged might be contributing to such high rates of vaccine refusal? This is a question that could use further exploration. What we can point to are the cultural environments that tend to be most conducive to distrusting science. The alternative medicine community in general has fostered an environment of distrust for authority, distrust of government and the medical establishment, and distrust of the institutions of science.
One might also argue that the powerful and privileged in particular would feel that “going along with the herd” cannot provide the best option for their children. Surely their privilege must afford them something better.
What about the “herd,” anyway. Should parents who refuse or delay their children’s vaccines be confident that the rest of the herd will protect them? Professor Emily Oster looks at the data, drills down further and explains why states should aim for 100% vaccination:
From a public health standpoint, this data argues for continuing to push to increase vaccination rates and stem any declines. A 95 percent vaccination rate in a state doesn’t mean every place in the state is at 95 percent. At rates even a bit lower, we start to see increases in whooping cough and measles cases. And remember that parents who choose not to vaccinate their kids are also putting other people’s kids at risk: Many of the victims of whooping cough are babies who are too young to be vaccinated.
The danger to the current generation of American children comes from the dissemination of misinformation and nonsense across the internet, airwaves, print media, and conversations among parents. The more that parents buy into this foolishness and refuse or delay their children’s vaccines, the weaker the herd becomes, and the more vulnerable every child (and adult) becomes, especially their own.
The danger doesn’t come from pediatricians, almost all of whom communicate the scientific fact that vaccines, unless medically contraindicated, are safe and effective in people as young as newborns and as old as the oldest person alive. And the danger doesn’t come from parents who understand their duty to protect their children and immunize them. In fact, according to Steven Reinberg, many responsible parents are becoming more than a little bit peeved with some of their friends, relatives, and neighbors:
[Pediatrician Paul] Offit thinks many parents are angry with those parents who won’t have their children vaccinated.
“You are starting to see pushback among parents who are upset at those who choose not to vaccinate their children,” he said. They are not only putting their own children at risk, he noted.
Parents and grandparents need to make sure they stay up-to-date with their own immunizations as well. That means getting an annual flu vaccine, 10-year boosters for tetanus, diphtheria, and pertussis, and the shingles vaccine (60 years old and up). The only excuse that’s left for not getting shots is they hurt. Get over it.